1 Data preparation

1.1 Outline

  • Load scripts: loads libraries and useful scripts used in the analyses; all .R files contained in scripts at the root of the factory are automatically loaded

  • Load data: imports datasets, and may contain some ad hoc changes to the data such as specific data cleaning (not used in other reports), new variables used in the analyses, etc.

1.2 Load packages


library(reportfactory)
library(here)
library(rio) 
library(tidyverse)
library(incidence)
library(distcrete)
library(epitrix)
library(earlyR)
library(projections)
library(linelist)
library(remotes)
library(janitor)
library(kableExtra)
library(DT)
library(cyphr)
library(chngpt)
library(lubridate)
library(ggpubr)
library(ggnewscale)

1.3 Load scripts

These scripts will load:

  • all scripts stored as .R files inside /scripts/
  • all scripts stored as .R files inside /src/

These scripts also contain routines to access the latest clean encrypted data (see next section).


reportfactory::rfh_load_scripts()

1.4 Load clean data

We import the latest NHS pathways data:


x <- import_pathways() %>%
  as_tibble()
x
## # A tibble: 204,109 x 11
##    site_type date       sex   age   ccg_code ccg_name count postcode nhs_region
##    <chr>     <date>     <chr> <chr> <chr>    <chr>    <int> <chr>    <chr>     
##  1 111       2020-03-18 fema… miss… e380000… nhs_glo…     1 gl34fe   South West
##  2 111       2020-03-18 fema… miss… e380001… nhs_sou…     1 ne325nn  North Eas…
##  3 111       2020-03-18 fema… 0-18  e380000… nhs_air…     8 bd57jr   North Eas…
##  4 111       2020-03-18 fema… 0-18  e380000… nhs_ash…     7 tn254ab  South East
##  5 111       2020-03-18 fema… 0-18  e380000… nhs_bar…    35 rm13ae   London    
##  6 111       2020-03-18 fema… 0-18  e380000… nhs_bar…     9 n111np   London    
##  7 111       2020-03-18 fema… 0-18  e380000… nhs_bar…    11 s752py   North Eas…
##  8 111       2020-03-18 fema… 0-18  e380000… nhs_bas…    19 ss143hg  East of E…
##  9 111       2020-03-18 fema… 0-18  e380000… nhs_bas…     6 dn227xf  North Eas…
## 10 111       2020-03-18 fema… 0-18  e380000… nhs_bat…     9 ba25rp   South West
## # … with 204,099 more rows, and 2 more variables: day <int>, weekday <fct>

We also import demographics data for NHS regions in England, used later in our analysis:


path <- here::here("data", "csv", "nhs_region_population_2018.csv")
nhs_region_pop <- rio::import(path) %>%
  mutate(nhs_region = str_to_title(gsub("_"," ",nhs_region)))

nhs_region_pop$nhs_region <- gsub(" Of ", " of ", nhs_region_pop$nhs_region)
nhs_region_pop$nhs_region <- gsub(" And ", " and ", nhs_region_pop$nhs_region)
nhs_region_pop
##                  nhs_region variable      value
## 1                North West     0-18 0.22538599
## 2  North East and Yorkshire     0-18 0.21876449
## 3                  Midlands     0-18 0.22564656
## 4           East of England     0-18 0.22810783
## 5                    London     0-18 0.23764782
## 6                South East     0-18 0.22458811
## 7                South West     0-18 0.20799797
## 8                North West    19-69 0.64274078
## 9  North East and Yorkshire    19-69 0.64437753
## 10                 Midlands    19-69 0.63876675
## 11          East of England    19-69 0.63034229
## 12                   London    19-69 0.67820084
## 13               South East    19-69 0.63267336
## 14               South West    19-69 0.63176131
## 15               North West   70-120 0.13187323
## 16 North East and Yorkshire   70-120 0.13685797
## 17                 Midlands   70-120 0.13558669
## 18          East of England   70-120 0.14154988
## 19                   London   70-120 0.08415135
## 20               South East   70-120 0.14273853
## 21               South West   70-120 0.16024072

Finally, we import publically available deaths per NHS region:


dth <- import_deaths() %>%
  mutate(nhs_region = str_to_title(gsub("_"," ",nhs_region)))

#truncation to account for reporting delay
delay_max <- 21

dth$nhs_region <- gsub(" Of ", " of ", dth$nhs_region)
dth$nhs_region <- gsub(" And ", " and ", dth$nhs_region)
dth
##      date_report               nhs_region deaths
## 1     2020-03-01          East of England      0
## 2     2020-03-02          East of England      1
## 3     2020-03-03          East of England      0
## 4     2020-03-04          East of England      0
## 5     2020-03-05          East of England      0
## 6     2020-03-06          East of England      1
## 7     2020-03-07          East of England      0
## 8     2020-03-08          East of England      0
## 9     2020-03-09          East of England      1
## 10    2020-03-10          East of England      0
## 11    2020-03-11          East of England      0
## 12    2020-03-12          East of England      0
## 13    2020-03-13          East of England      1
## 14    2020-03-14          East of England      2
## 15    2020-03-15          East of England      2
## 16    2020-03-16          East of England      1
## 17    2020-03-17          East of England      1
## 18    2020-03-18          East of England      5
## 19    2020-03-19          East of England      4
## 20    2020-03-20          East of England      2
## 21    2020-03-21          East of England     11
## 22    2020-03-22          East of England     12
## 23    2020-03-23          East of England     11
## 24    2020-03-24          East of England     19
## 25    2020-03-25          East of England     26
## 26    2020-03-26          East of England     36
## 27    2020-03-27          East of England     38
## 28    2020-03-28          East of England     28
## 29    2020-03-29          East of England     43
## 30    2020-03-30          East of England     45
## 31    2020-03-31          East of England     70
## 32    2020-04-01          East of England     62
## 33    2020-04-02          East of England     65
## 34    2020-04-03          East of England     80
## 35    2020-04-04          East of England     71
## 36    2020-04-05          East of England     76
## 37    2020-04-06          East of England     71
## 38    2020-04-07          East of England     93
## 39    2020-04-08          East of England    111
## 40    2020-04-09          East of England     87
## 41    2020-04-10          East of England     74
## 42    2020-04-11          East of England     92
## 43    2020-04-12          East of England    100
## 44    2020-04-13          East of England     78
## 45    2020-04-14          East of England     61
## 46    2020-04-15          East of England     82
## 47    2020-04-16          East of England     74
## 48    2020-04-17          East of England     86
## 49    2020-04-18          East of England     64
## 50    2020-04-19          East of England     67
## 51    2020-04-20          East of England     67
## 52    2020-04-21          East of England     75
## 53    2020-04-22          East of England     67
## 54    2020-04-23          East of England     49
## 55    2020-04-24          East of England     66
## 56    2020-04-25          East of England     54
## 57    2020-04-26          East of England     48
## 58    2020-04-27          East of England     46
## 59    2020-04-28          East of England     58
## 60    2020-04-29          East of England     32
## 61    2020-04-30          East of England     45
## 62    2020-05-01          East of England     49
## 63    2020-05-02          East of England     29
## 64    2020-05-03          East of England     41
## 65    2020-05-04          East of England     19
## 66    2020-05-05          East of England     36
## 67    2020-05-06          East of England     31
## 68    2020-05-07          East of England     33
## 69    2020-05-08          East of England     33
## 70    2020-05-09          East of England     29
## 71    2020-05-10          East of England     22
## 72    2020-05-11          East of England     18
## 73    2020-05-12          East of England     21
## 74    2020-05-13          East of England     27
## 75    2020-05-14          East of England     26
## 76    2020-05-15          East of England     19
## 77    2020-05-16          East of England     26
## 78    2020-05-17          East of England     17
## 79    2020-05-18          East of England     25
## 80    2020-05-19          East of England     15
## 81    2020-05-20          East of England     26
## 82    2020-05-21          East of England     21
## 83    2020-05-22          East of England     13
## 84    2020-05-23          East of England     12
## 85    2020-05-24          East of England     17
## 86    2020-05-25          East of England     25
## 87    2020-05-26          East of England     14
## 88    2020-05-27          East of England     12
## 89    2020-05-28          East of England     17
## 90    2020-05-29          East of England     16
## 91    2020-05-30          East of England      9
## 92    2020-05-31          East of England      8
## 93    2020-06-01          East of England     17
## 94    2020-06-02          East of England     14
## 95    2020-06-03          East of England     10
## 96    2020-06-04          East of England      7
## 97    2020-06-05          East of England     14
## 98    2020-06-06          East of England      5
## 99    2020-06-07          East of England      9
## 100   2020-06-08          East of England      7
## 101   2020-06-09          East of England      6
## 102   2020-06-10          East of England      8
## 103   2020-06-11          East of England      1
## 104   2020-06-12          East of England      9
## 105   2020-06-13          East of England      5
## 106   2020-06-14          East of England      4
## 107   2020-06-15          East of England      8
## 108   2020-06-16          East of England      3
## 109   2020-06-17          East of England      7
## 110   2020-06-18          East of England      4
## 111   2020-06-19          East of England      7
## 112   2020-06-20          East of England      4
## 113   2020-06-21          East of England      3
## 114   2020-06-22          East of England      6
## 115   2020-06-23          East of England      5
## 116   2020-06-24          East of England      4
## 117   2020-06-25          East of England      1
## 118   2020-06-26          East of England      5
## 119   2020-06-27          East of England      6
## 120   2020-06-28          East of England      8
## 121   2020-06-29          East of England      4
## 122   2020-06-30          East of England      5
## 123   2020-07-01          East of England      2
## 124   2020-07-02          East of England      5
## 125   2020-07-03          East of England      0
## 126   2020-07-04          East of England      3
## 127   2020-07-05          East of England      1
## 128   2020-07-06          East of England      2
## 129   2020-07-07          East of England      2
## 130   2020-07-08          East of England      0
## 131   2020-07-09          East of England      8
## 132   2020-07-10          East of England      4
## 133   2020-07-11          East of England      2
## 134   2020-07-12          East of England      1
## 135   2020-07-13          East of England      7
## 136   2020-07-14          East of England      2
## 137   2020-07-15          East of England      0
## 138   2020-07-16          East of England      0
## 139   2020-07-17          East of England      0
## 140   2020-07-18          East of England      0
## 141   2020-07-19          East of England      1
## 142   2020-07-20          East of England      1
## 143   2020-07-21          East of England      1
## 144   2020-07-22          East of England      1
## 145   2020-07-23          East of England      1
## 146   2020-07-24          East of England      1
## 147   2020-07-25          East of England      0
## 148   2020-07-26          East of England      1
## 149   2020-07-27          East of England      1
## 150   2020-07-28          East of England      1
## 151   2020-07-29          East of England      0
## 152   2020-07-30          East of England      0
## 153   2020-07-31          East of England      1
## 154   2020-08-01          East of England      0
## 155   2020-08-02          East of England      0
## 156   2020-08-03          East of England      0
## 157   2020-08-04          East of England      1
## 158   2020-08-05          East of England      1
## 159   2020-08-06          East of England      0
## 160   2020-08-07          East of England      1
## 161   2020-08-08          East of England      0
## 162   2020-08-09          East of England      0
## 163   2020-03-01                   London      0
## 164   2020-03-02                   London      0
## 165   2020-03-03                   London      0
## 166   2020-03-04                   London      0
## 167   2020-03-05                   London      0
## 168   2020-03-06                   London      1
## 169   2020-03-07                   London      0
## 170   2020-03-08                   London      0
## 171   2020-03-09                   London      1
## 172   2020-03-10                   London      0
## 173   2020-03-11                   London      5
## 174   2020-03-12                   London      6
## 175   2020-03-13                   London     10
## 176   2020-03-14                   London     13
## 177   2020-03-15                   London      9
## 178   2020-03-16                   London     15
## 179   2020-03-17                   London     23
## 180   2020-03-18                   London     27
## 181   2020-03-19                   London     25
## 182   2020-03-20                   London     44
## 183   2020-03-21                   London     49
## 184   2020-03-22                   London     54
## 185   2020-03-23                   London     63
## 186   2020-03-24                   London     86
## 187   2020-03-25                   London    112
## 188   2020-03-26                   London    129
## 189   2020-03-27                   London    129
## 190   2020-03-28                   London    122
## 191   2020-03-29                   London    145
## 192   2020-03-30                   London    149
## 193   2020-03-31                   London    181
## 194   2020-04-01                   London    202
## 195   2020-04-02                   London    191
## 196   2020-04-03                   London    197
## 197   2020-04-04                   London    231
## 198   2020-04-05                   London    195
## 199   2020-04-06                   London    197
## 200   2020-04-07                   London    220
## 201   2020-04-08                   London    239
## 202   2020-04-09                   London    206
## 203   2020-04-10                   London    171
## 204   2020-04-11                   London    178
## 205   2020-04-12                   London    158
## 206   2020-04-13                   London    166
## 207   2020-04-14                   London    143
## 208   2020-04-15                   London    142
## 209   2020-04-16                   London    140
## 210   2020-04-17                   London    100
## 211   2020-04-18                   London    101
## 212   2020-04-19                   London    103
## 213   2020-04-20                   London     96
## 214   2020-04-21                   London     94
## 215   2020-04-22                   London    109
## 216   2020-04-23                   London     77
## 217   2020-04-24                   London     71
## 218   2020-04-25                   London     58
## 219   2020-04-26                   London     53
## 220   2020-04-27                   London     51
## 221   2020-04-28                   London     44
## 222   2020-04-29                   London     45
## 223   2020-04-30                   London     40
## 224   2020-05-01                   London     41
## 225   2020-05-02                   London     41
## 226   2020-05-03                   London     36
## 227   2020-05-04                   London     30
## 228   2020-05-05                   London     25
## 229   2020-05-06                   London     37
## 230   2020-05-07                   London     37
## 231   2020-05-08                   London     30
## 232   2020-05-09                   London     23
## 233   2020-05-10                   London     26
## 234   2020-05-11                   London     18
## 235   2020-05-12                   London     18
## 236   2020-05-13                   London     17
## 237   2020-05-14                   London     20
## 238   2020-05-15                   London     18
## 239   2020-05-16                   London     14
## 240   2020-05-17                   London     15
## 241   2020-05-18                   London     11
## 242   2020-05-19                   London     14
## 243   2020-05-20                   London     19
## 244   2020-05-21                   London     12
## 245   2020-05-22                   London     10
## 246   2020-05-23                   London      6
## 247   2020-05-24                   London      7
## 248   2020-05-25                   London      9
## 249   2020-05-26                   London     14
## 250   2020-05-27                   London      7
## 251   2020-05-28                   London      8
## 252   2020-05-29                   London      7
## 253   2020-05-30                   London     12
## 254   2020-05-31                   London      6
## 255   2020-06-01                   London     10
## 256   2020-06-02                   London      8
## 257   2020-06-03                   London      6
## 258   2020-06-04                   London      8
## 259   2020-06-05                   London      4
## 260   2020-06-06                   London      0
## 261   2020-06-07                   London      5
## 262   2020-06-08                   London      5
## 263   2020-06-09                   London      5
## 264   2020-06-10                   London      8
## 265   2020-06-11                   London      5
## 266   2020-06-12                   London      3
## 267   2020-06-13                   London      3
## 268   2020-06-14                   London      3
## 269   2020-06-15                   London      1
## 270   2020-06-16                   London      2
## 271   2020-06-17                   London      1
## 272   2020-06-18                   London      2
## 273   2020-06-19                   London      5
## 274   2020-06-20                   London      3
## 275   2020-06-21                   London      4
## 276   2020-06-22                   London      2
## 277   2020-06-23                   London      1
## 278   2020-06-24                   London      4
## 279   2020-06-25                   London      3
## 280   2020-06-26                   London      2
## 281   2020-06-27                   London      1
## 282   2020-06-28                   London      2
## 283   2020-06-29                   London      2
## 284   2020-06-30                   London      1
## 285   2020-07-01                   London      2
## 286   2020-07-02                   London      2
## 287   2020-07-03                   London      2
## 288   2020-07-04                   London      1
## 289   2020-07-05                   London      3
## 290   2020-07-06                   London      2
## 291   2020-07-07                   London      1
## 292   2020-07-08                   London      3
## 293   2020-07-09                   London      4
## 294   2020-07-10                   London      0
## 295   2020-07-11                   London      1
## 296   2020-07-12                   London      1
## 297   2020-07-13                   London      1
## 298   2020-07-14                   London      0
## 299   2020-07-15                   London      2
## 300   2020-07-16                   London      0
## 301   2020-07-17                   London      0
## 302   2020-07-18                   London      2
## 303   2020-07-19                   London      0
## 304   2020-07-20                   London      0
## 305   2020-07-21                   London      1
## 306   2020-07-22                   London      0
## 307   2020-07-23                   London      2
## 308   2020-07-24                   London      0
## 309   2020-07-25                   London      1
## 310   2020-07-26                   London      0
## 311   2020-07-27                   London      1
## 312   2020-07-28                   London      0
## 313   2020-07-29                   London      0
## 314   2020-07-30                   London      0
## 315   2020-07-31                   London      0
## 316   2020-08-01                   London      0
## 317   2020-08-02                   London      2
## 318   2020-08-03                   London      0
## 319   2020-08-04                   London      0
## 320   2020-08-05                   London      0
## 321   2020-08-06                   London      1
## 322   2020-08-07                   London      0
## 323   2020-08-08                   London      0
## 324   2020-08-09                   London      0
## 325   2020-03-01                 Midlands      0
## 326   2020-03-02                 Midlands      0
## 327   2020-03-03                 Midlands      1
## 328   2020-03-04                 Midlands      0
## 329   2020-03-05                 Midlands      0
## 330   2020-03-06                 Midlands      0
## 331   2020-03-07                 Midlands      0
## 332   2020-03-08                 Midlands      2
## 333   2020-03-09                 Midlands      1
## 334   2020-03-10                 Midlands      0
## 335   2020-03-11                 Midlands      2
## 336   2020-03-12                 Midlands      6
## 337   2020-03-13                 Midlands      5
## 338   2020-03-14                 Midlands      4
## 339   2020-03-15                 Midlands      5
## 340   2020-03-16                 Midlands     11
## 341   2020-03-17                 Midlands      8
## 342   2020-03-18                 Midlands     13
## 343   2020-03-19                 Midlands      8
## 344   2020-03-20                 Midlands     28
## 345   2020-03-21                 Midlands     13
## 346   2020-03-22                 Midlands     31
## 347   2020-03-23                 Midlands     33
## 348   2020-03-24                 Midlands     41
## 349   2020-03-25                 Midlands     48
## 350   2020-03-26                 Midlands     64
## 351   2020-03-27                 Midlands     72
## 352   2020-03-28                 Midlands     89
## 353   2020-03-29                 Midlands     92
## 354   2020-03-30                 Midlands     90
## 355   2020-03-31                 Midlands    123
## 356   2020-04-01                 Midlands    140
## 357   2020-04-02                 Midlands    142
## 358   2020-04-03                 Midlands    124
## 359   2020-04-04                 Midlands    151
## 360   2020-04-05                 Midlands    164
## 361   2020-04-06                 Midlands    140
## 362   2020-04-07                 Midlands    123
## 363   2020-04-08                 Midlands    186
## 364   2020-04-09                 Midlands    139
## 365   2020-04-10                 Midlands    127
## 366   2020-04-11                 Midlands    142
## 367   2020-04-12                 Midlands    139
## 368   2020-04-13                 Midlands    120
## 369   2020-04-14                 Midlands    116
## 370   2020-04-15                 Midlands    147
## 371   2020-04-16                 Midlands    102
## 372   2020-04-17                 Midlands    118
## 373   2020-04-18                 Midlands    115
## 374   2020-04-19                 Midlands     92
## 375   2020-04-20                 Midlands    107
## 376   2020-04-21                 Midlands     86
## 377   2020-04-22                 Midlands     78
## 378   2020-04-23                 Midlands    103
## 379   2020-04-24                 Midlands     79
## 380   2020-04-25                 Midlands     72
## 381   2020-04-26                 Midlands     81
## 382   2020-04-27                 Midlands     74
## 383   2020-04-28                 Midlands     68
## 384   2020-04-29                 Midlands     53
## 385   2020-04-30                 Midlands     56
## 386   2020-05-01                 Midlands     64
## 387   2020-05-02                 Midlands     51
## 388   2020-05-03                 Midlands     52
## 389   2020-05-04                 Midlands     61
## 390   2020-05-05                 Midlands     59
## 391   2020-05-06                 Midlands     59
## 392   2020-05-07                 Midlands     48
## 393   2020-05-08                 Midlands     34
## 394   2020-05-09                 Midlands     37
## 395   2020-05-10                 Midlands     42
## 396   2020-05-11                 Midlands     33
## 397   2020-05-12                 Midlands     45
## 398   2020-05-13                 Midlands     40
## 399   2020-05-14                 Midlands     38
## 400   2020-05-15                 Midlands     40
## 401   2020-05-16                 Midlands     34
## 402   2020-05-17                 Midlands     31
## 403   2020-05-18                 Midlands     36
## 404   2020-05-19                 Midlands     35
## 405   2020-05-20                 Midlands     36
## 406   2020-05-21                 Midlands     32
## 407   2020-05-22                 Midlands     27
## 408   2020-05-23                 Midlands     34
## 409   2020-05-24                 Midlands     20
## 410   2020-05-25                 Midlands     26
## 411   2020-05-26                 Midlands     33
## 412   2020-05-27                 Midlands     29
## 413   2020-05-28                 Midlands     28
## 414   2020-05-29                 Midlands     20
## 415   2020-05-30                 Midlands     21
## 416   2020-05-31                 Midlands     22
## 417   2020-06-01                 Midlands     20
## 418   2020-06-02                 Midlands     22
## 419   2020-06-03                 Midlands     24
## 420   2020-06-04                 Midlands     16
## 421   2020-06-05                 Midlands     21
## 422   2020-06-06                 Midlands     20
## 423   2020-06-07                 Midlands     17
## 424   2020-06-08                 Midlands     16
## 425   2020-06-09                 Midlands     18
## 426   2020-06-10                 Midlands     15
## 427   2020-06-11                 Midlands     13
## 428   2020-06-12                 Midlands     12
## 429   2020-06-13                 Midlands      6
## 430   2020-06-14                 Midlands     18
## 431   2020-06-15                 Midlands     12
## 432   2020-06-16                 Midlands     15
## 433   2020-06-17                 Midlands     11
## 434   2020-06-18                 Midlands     15
## 435   2020-06-19                 Midlands     10
## 436   2020-06-20                 Midlands     15
## 437   2020-06-21                 Midlands     14
## 438   2020-06-22                 Midlands     14
## 439   2020-06-23                 Midlands     16
## 440   2020-06-24                 Midlands     15
## 441   2020-06-25                 Midlands     18
## 442   2020-06-26                 Midlands      5
## 443   2020-06-27                 Midlands      5
## 444   2020-06-28                 Midlands      7
## 445   2020-06-29                 Midlands      6
## 446   2020-06-30                 Midlands      6
## 447   2020-07-01                 Midlands      7
## 448   2020-07-02                 Midlands     10
## 449   2020-07-03                 Midlands      3
## 450   2020-07-04                 Midlands      4
## 451   2020-07-05                 Midlands      6
## 452   2020-07-06                 Midlands      5
## 453   2020-07-07                 Midlands      3
## 454   2020-07-08                 Midlands      5
## 455   2020-07-09                 Midlands      9
## 456   2020-07-10                 Midlands      3
## 457   2020-07-11                 Midlands      0
## 458   2020-07-12                 Midlands      5
## 459   2020-07-13                 Midlands      1
## 460   2020-07-14                 Midlands      1
## 461   2020-07-15                 Midlands      6
## 462   2020-07-16                 Midlands      2
## 463   2020-07-17                 Midlands      3
## 464   2020-07-18                 Midlands      3
## 465   2020-07-19                 Midlands      3
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## 467   2020-07-21                 Midlands      1
## 468   2020-07-22                 Midlands      2
## 469   2020-07-23                 Midlands      6
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## 501   2020-03-15 North East and Yorkshire      2
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## 505   2020-03-19 North East and Yorkshire      6
## 506   2020-03-20 North East and Yorkshire      5
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## 531   2020-04-14 North East and Yorkshire    107
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## 535   2020-04-18 North East and Yorkshire     95
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## 537   2020-04-20 North East and Yorkshire    100
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## 551   2020-05-04 North East and Yorkshire     49
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## 582   2020-06-04 North East and Yorkshire     17
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## 594   2020-06-16 North East and Yorkshire     10
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## 599   2020-06-21 North East and Yorkshire      4
## 600   2020-06-22 North East and Yorkshire      7
## 601   2020-06-23 North East and Yorkshire      8
## 602   2020-06-24 North East and Yorkshire     10
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## 604   2020-06-26 North East and Yorkshire      7
## 605   2020-06-27 North East and Yorkshire      4
## 606   2020-06-28 North East and Yorkshire      5
## 607   2020-06-29 North East and Yorkshire      2
## 608   2020-06-30 North East and Yorkshire      7
## 609   2020-07-01 North East and Yorkshire      1
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## 611   2020-07-03 North East and Yorkshire      4
## 612   2020-07-04 North East and Yorkshire      4
## 613   2020-07-05 North East and Yorkshire      3
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## 615   2020-07-07 North East and Yorkshire      3
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## 617   2020-07-09 North East and Yorkshire      0
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## 622   2020-07-14 North East and Yorkshire      1
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## 642   2020-08-03 North East and Yorkshire      1
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## 958   2020-07-26               South East      3
## 959   2020-07-27               South East      0
## 960   2020-07-28               South East      3
## 961   2020-07-29               South East      2
## 962   2020-07-30               South East      3
## 963   2020-07-31               South East      1
## 964   2020-08-01               South East      2
## 965   2020-08-02               South East      3
## 966   2020-08-03               South East      0
## 967   2020-08-04               South East      0
## 968   2020-08-05               South East      0
## 969   2020-08-06               South East      0
## 970   2020-08-07               South East      0
## 971   2020-08-08               South East      1
## 972   2020-08-09               South East      0
## 973   2020-03-01               South West      0
## 974   2020-03-02               South West      0
## 975   2020-03-03               South West      0
## 976   2020-03-04               South West      0
## 977   2020-03-05               South West      0
## 978   2020-03-06               South West      0
## 979   2020-03-07               South West      0
## 980   2020-03-08               South West      0
## 981   2020-03-09               South West      0
## 982   2020-03-10               South West      0
## 983   2020-03-11               South West      1
## 984   2020-03-12               South West      0
## 985   2020-03-13               South West      0
## 986   2020-03-14               South West      1
## 987   2020-03-15               South West      0
## 988   2020-03-16               South West      0
## 989   2020-03-17               South West      2
## 990   2020-03-18               South West      2
## 991   2020-03-19               South West      4
## 992   2020-03-20               South West      3
## 993   2020-03-21               South West      6
## 994   2020-03-22               South West      7
## 995   2020-03-23               South West      8
## 996   2020-03-24               South West      7
## 997   2020-03-25               South West      9
## 998   2020-03-26               South West     11
## 999   2020-03-27               South West     13
## 1000  2020-03-28               South West     21
## 1001  2020-03-29               South West     18
## 1002  2020-03-30               South West     23
## 1003  2020-03-31               South West     23
## 1004  2020-04-01               South West     21
## 1005  2020-04-02               South West     23
## 1006  2020-04-03               South West     30
## 1007  2020-04-04               South West     42
## 1008  2020-04-05               South West     32
## 1009  2020-04-06               South West     34
## 1010  2020-04-07               South West     39
## 1011  2020-04-08               South West     47
## 1012  2020-04-09               South West     24
## 1013  2020-04-10               South West     46
## 1014  2020-04-11               South West     43
## 1015  2020-04-12               South West     23
## 1016  2020-04-13               South West     27
## 1017  2020-04-14               South West     24
## 1018  2020-04-15               South West     32
## 1019  2020-04-16               South West     29
## 1020  2020-04-17               South West     33
## 1021  2020-04-18               South West     25
## 1022  2020-04-19               South West     31
## 1023  2020-04-20               South West     26
## 1024  2020-04-21               South West     26
## 1025  2020-04-22               South West     23
## 1026  2020-04-23               South West     17
## 1027  2020-04-24               South West     19
## 1028  2020-04-25               South West     15
## 1029  2020-04-26               South West     27
## 1030  2020-04-27               South West     13
## 1031  2020-04-28               South West     17
## 1032  2020-04-29               South West     15
## 1033  2020-04-30               South West     26
## 1034  2020-05-01               South West      6
## 1035  2020-05-02               South West      7
## 1036  2020-05-03               South West     10
## 1037  2020-05-04               South West     17
## 1038  2020-05-05               South West     14
## 1039  2020-05-06               South West     19
## 1040  2020-05-07               South West     16
## 1041  2020-05-08               South West      6
## 1042  2020-05-09               South West     11
## 1043  2020-05-10               South West      5
## 1044  2020-05-11               South West      8
## 1045  2020-05-12               South West      7
## 1046  2020-05-13               South West      7
## 1047  2020-05-14               South West      6
## 1048  2020-05-15               South West      4
## 1049  2020-05-16               South West      4
## 1050  2020-05-17               South West      6
## 1051  2020-05-18               South West      4
## 1052  2020-05-19               South West      6
## 1053  2020-05-20               South West      1
## 1054  2020-05-21               South West      9
## 1055  2020-05-22               South West      7
## 1056  2020-05-23               South West      6
## 1057  2020-05-24               South West      3
## 1058  2020-05-25               South West      8
## 1059  2020-05-26               South West     11
## 1060  2020-05-27               South West      5
## 1061  2020-05-28               South West     10
## 1062  2020-05-29               South West      7
## 1063  2020-05-30               South West      3
## 1064  2020-05-31               South West      2
## 1065  2020-06-01               South West      7
## 1066  2020-06-02               South West      2
## 1067  2020-06-03               South West      7
## 1068  2020-06-04               South West      2
## 1069  2020-06-05               South West      2
## 1070  2020-06-06               South West      1
## 1071  2020-06-07               South West      3
## 1072  2020-06-08               South West      3
## 1073  2020-06-09               South West      0
## 1074  2020-06-10               South West      1
## 1075  2020-06-11               South West      2
## 1076  2020-06-12               South West      2
## 1077  2020-06-13               South West      2
## 1078  2020-06-14               South West      0
## 1079  2020-06-15               South West      2
## 1080  2020-06-16               South West      2
## 1081  2020-06-17               South West      0
## 1082  2020-06-18               South West      0
## 1083  2020-06-19               South West      0
## 1084  2020-06-20               South West      2
## 1085  2020-06-21               South West      0
## 1086  2020-06-22               South West      1
## 1087  2020-06-23               South West      1
## 1088  2020-06-24               South West      1
## 1089  2020-06-25               South West      0
## 1090  2020-06-26               South West      3
## 1091  2020-06-27               South West      0
## 1092  2020-06-28               South West      0
## 1093  2020-06-29               South West      1
## 1094  2020-06-30               South West      0
## 1095  2020-07-01               South West      0
## 1096  2020-07-02               South West      0
## 1097  2020-07-03               South West      0
## 1098  2020-07-04               South West      0
## 1099  2020-07-05               South West      1
## 1100  2020-07-06               South West      0
## 1101  2020-07-07               South West      0
## 1102  2020-07-08               South West      2
## 1103  2020-07-09               South West      0
## 1104  2020-07-10               South West      1
## 1105  2020-07-11               South West      0
## 1106  2020-07-12               South West      0
## 1107  2020-07-13               South West      1
## 1108  2020-07-14               South West      0
## 1109  2020-07-15               South West      0
## 1110  2020-07-16               South West      0
## 1111  2020-07-17               South West      1
## 1112  2020-07-18               South West      0
## 1113  2020-07-19               South West      0
## 1114  2020-07-20               South West      0
## 1115  2020-07-21               South West      0
## 1116  2020-07-22               South West      0
## 1117  2020-07-23               South West      0
## 1118  2020-07-24               South West      0
## 1119  2020-07-25               South West      0
## 1120  2020-07-26               South West      0
## 1121  2020-07-27               South West      0
## 1122  2020-07-28               South West      0
## 1123  2020-07-29               South West      0
## 1124  2020-07-30               South West      1
## 1125  2020-07-31               South West      0
## 1126  2020-08-01               South West      0
## 1127  2020-08-02               South West      0
## 1128  2020-08-03               South West      0
## 1129  2020-08-04               South West      0
## 1130  2020-08-05               South West      0
## 1131  2020-08-06               South West      0
## 1132  2020-08-07               South West      0
## 1133  2020-08-08               South West      0
## 1134  2020-08-09               South West      0

1.5 Completion date

We extract the completion date from the NHS Pathways file timestamp:


database_date <- attr(x, "timestamp")
database_date
## [1] "2020-08-10"

The completion date of the NHS Pathways data is Monday 10 Aug 2020.

1.6 Auxiliary functions

These are functions which will be used further in the analyses.

Function to estimate the generalised R-squared as the proportion of deviance explained by a given model:


## Function to calculate R2 for Poisson model
## not adjusted for model complexity but all models have the same DF here

Rsq <- function(x) {
  1 - (x$deviance / x$null.deviance)
}

Function to extract growth rates per region as well as halving times, and the associated 95% confidence intervals:


## function to extract the coefficients, find the level of the intercept,
## reconstruct the values of r, get confidence intervals

get_r <- function(model) {
  ##  extract coefficients and conf int
  out <- data.frame(r = coef(model))  %>%
    rownames_to_column("var") %>% 
    cbind(confint(model)) %>%
    filter(!grepl("day_of_week", var)) %>% 
    filter(grepl("day", var)) %>%
    rename(lower_95 = "2.5 %",
           upper_95 = "97.5 %") %>%
    mutate(var = sub("day:", "", var))
  
  ## reconstruct values: intercept + region-coefficient
  for (i in 2:nrow(out)) {
    out[i, -1] <- out[1, -1] + out[i, -1]
  }
  
  ## find the name of the intercept, restore regions names
  out <- out %>%
    mutate(nhs_region = model$xlevels$nhs_region) %>%
    select(nhs_region, everything(), -var)
  
  ## find halving times
  halving <- log(0.5) / out[,-1] %>%
    rename(halving_t = r,
           halving_t_lower_95 = lower_95,
           halving_t_upper_95 = upper_95)
  
  ## set halving times with exclusion intervals to NA
  no_halving <- out$lower_95 < 0 & out$upper_95 > 0
  halving[no_halving, ] <- NA_real_
  
  ## return all data
  cbind(out, halving)
  
}

Functions used in the correlation analysis between NHS Pathways reports and deaths:

## Function to calculate Pearson's correlation between deaths and lagged
## reports. Note that `pearson` can be replaced with `spearman` for rank
## correlation.

getcor <- function(x, ndx) {
  return(cor(x$deaths[ndx],
             x$note_lag[ndx],
             use = "complete.obs",
             method = "pearson"))
}

## Catch if sample size throws an error
getcor2 <- possibly(getcor, otherwise = NA)

getboot <- function(x) {
  result <- boot::boot.ci(boot::boot(x, getcor2, R = 1000), 
                           type = "bca")
  return(data.frame(n = sum(!is.na(x$note_lag) & !is.na(x$deaths)),
                    r = result$t0,
                    r_low = result$bca[4],
                    r_hi = result$bca[5]))
}

Function to classify the day of the week into weekend, Monday, and the rest:


## Fn to add day of week
day_of_week <- function(df) {
  df %>% 
    dplyr::mutate(day_of_week = lubridate::wday(date, label = TRUE)) %>% 
    dplyr::mutate(day_of_week = dplyr::case_when(
      day_of_week %in% c("Sat", "Sun") ~ "weekend",
      day_of_week %in% c("Mon") ~ "monday",
      !(day_of_week %in% c("Sat", "Sun", "Mon")) ~ "rest_of_week"
    ) %>% 
      factor(levels = c("rest_of_week", "monday", "weekend")))
}

Custom color palettes, color scales, and vectors of colors:


pal <- c("#006212",
         "#ae3cab",
         "#00db90",
         "#960c00",
         "#55aaff",
         "#ff7e78",
         "#00388d")

age.pal <- viridis::viridis(3,begin = 0.1, end = 0.7)

3 Comparison with deaths time series

3.1 Outline

We want to explore the correlation between NHS Pathways reports and deaths, and assess the potential for reports to be used as an early warning system for disease resurgence.

Death data are publically available. We truncate the time series to avoid bias from reporting delay - we assume a conservative delay of three weeks.

3.2 Lagged correlation

We calculate Pearson’s correlation coefficient between deaths and NHS Pathways notifications using different lags. Confidence intervals are obtained using bootstrap. Note that results were also confirmed using Spearman’s rank correlation.

First we join the NHS Pathways and death data, and aggregate over all England:

## truncate death data for reporting delay
trunc_date <- max(dth$date_report) - delay_max

dth_trunc <- dth %>%
  rename(date = date_report) %>%
  filter(date <= trunc_date) 

## join with notification data
all_data <- x %>% 
  filter(!is.na(nhs_region)) %>%
  group_by(date, nhs_region) %>%
  summarise(count = sum(count, na.rm = T)) %>%
  ungroup %>%
  inner_join(dth_trunc,
             by = c("date","nhs_region"))

all_tot <- all_data %>%
  group_by(date) %>%
  summarise(count = sum(count, na.rm = TRUE),
            deaths = sum(deaths, na.rm = TRUE)) 

We calculate correlation with lagged NHS Pathways reports from 0 to 30 days behind deaths:


## Calculate all correlations + bootstrap CIs
lag_cor <- data.frame()
for (i in 0:30) {
  
  ## lag reports
  summary <- all_tot %>% 
    mutate(note_lag = lag(count, i)) %>%
    ## calculate rank correlation and bootstrap CI
    getboot(.) %>%
    mutate(lag = i)

  lag_cor <- bind_rows(lag_cor, summary)
}

cor_vs_lag <- ggplot(lag_cor, aes(lag, r)) +
  theme_bw() +
  geom_ribbon(aes(ymin = r_low, ymax = r_hi), alpha = 0.2) +
  geom_hline(yintercept = 0, lty = "longdash") +
  geom_point() +
  geom_line() +
  labs(x = "Lag between NHS pathways and death data (days)",
       y = "Pearson's correlation") +
  large_txt
cor_vs_lag


l_opt <- which.max(lag_cor$r)

This analysis suggests that the best lag is 23 days. We then compare and plot the number of deaths reported against the number of NHS Pathways reports lagged by 23 days.


all_tot <- all_tot %>%
  rename(date_death = date) %>%
  mutate(note_lag = lag(count, lag_cor$lag[l_opt]),
         note_lag_c = (note_lag - mean(note_lag, na.rm = T)),
         date_note = lag(date_death,16))

lag_mod <- glm(deaths ~ note_lag, data = all_tot, family = "quasipoisson")

summary(lag_mod)
## 
## Call:
## glm(formula = deaths ~ note_lag, family = "quasipoisson", data = all_tot)
## 
## Deviance Residuals: 
##     Min       1Q   Median       3Q      Max  
## -16.362   -6.027   -1.448    4.302   10.669  
## 
## Coefficients:
##              Estimate Std. Error t value Pr(>|t|)    
## (Intercept) 4.327e+00  7.457e-02   58.02   <2e-16 ***
## note_lag    1.676e-05  7.787e-07   21.52   <2e-16 ***
## ---
## Signif. codes:  0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1
## 
## (Dispersion parameter for quasipoisson family taken to be 36.46705)
## 
##     Null deviance: 18828.5  on 100  degrees of freedom
## Residual deviance:  3911.6  on  99  degrees of freedom
##   (23 observations deleted due to missingness)
## AIC: NA
## 
## Number of Fisher Scoring iterations: 5

exp(coefficients(lag_mod))
## (Intercept)    note_lag 
##   75.690175    1.000017
exp(confint(lag_mod))
##                 2.5 %    97.5 %
## (Intercept) 65.210724 87.361517
## note_lag     1.000015  1.000018

Rsq(lag_mod)
## [1] 0.792252

mod_fit <- as.data.frame(predict(lag_mod, type = "link", se.fit = TRUE)[1:2])

all_tot_pred <- 
  all_tot %>%
  filter(!is.na(note_lag)) %>%
  mutate(pred = mod_fit$fit,
         pred.se = mod_fit$se.fit,
         low = exp(pred - 1.96*pred.se),
         hi = exp(pred + 1.96*pred.se))


glm_fit <- all_tot_pred %>% 
    filter(!is.na(note_lag)) %>%
  ggplot(aes(x = note_lag, y = deaths)) +
  geom_point() + 
  geom_line(aes(y = exp(pred))) + 
  geom_ribbon(aes(ymin = low, ymax = hi), alpha = 0.3, col = "grey") +
  theme_bw() +
  labs(y = "Daily number of\ndeaths reported",
       x = "Daily number of NHS Pathways reports") +
  large_txt

glm_fit

4 Supplementary figures

4.1 Serial interval distribution

This is a comparison of gamma versus lognormal distribution for the serial interval used to convert r to R in our analysis. Both distributions are parameterised with mean 4.7 and standard deviation 2.9.

SI_param <- epitrix::gamma_mucv2shapescale(4.7, 2.9/4.7)
SI_distribution <- distcrete::distcrete("gamma", interval = 1,
                                        shape = SI_param$shape,
                                        scale = SI_param$scale, w = 0.5)

SI_distribution2 <- distcrete::distcrete("lnorm", interval = 1,
                                        meanlog = log(4.7),
                                        sdlog = log(2.9), w = 0.5)

SI_dist1 <- data.frame(x = SI_distribution$r(1e5)) 
SI_dist1 <- count(SI_dist1, x) %>%
    ggplot() +
    geom_col(aes(x = x, y = n)) +
    labs(x = "Serial interval (days)", y = "Frequency") +
    scale_x_continuous(breaks = seq(0, 30, 5)) +
    theme_bw()

SI_dist2 <- data.frame(x = SI_distribution2$r(1e5)) 
SI_dist2 <- count(SI_dist2, x) %>%
    ggplot() +
    geom_col(aes(x = x, y = n)) +
    labs(x = "Serial interval (days)", y = "Frequency") +
    scale_x_continuous(breaks = seq(0, 200, 20), limits = c(0, 200)) +
    theme_bw()


ggpubr::ggarrange(SI_dist1,
                  SI_dist2,
                  nrow = 1,
                  labels = "AUTO") 

4.2 Sensitivity analysis - 7 or 21 days moving window

We reproduce the window analysis with either a 7 or 21 days window for sensitivity purposes.

First with the 7 days window:

## set moving time window (1/2/3 weeks)
w <- 7

# create empty df
r_all_sliding_7days <- NULL

## make data for model
x_model_all_moving <- x %>%
  filter(!is.na(nhs_region)) %>% 
  group_by(date, nhs_region) %>%
  summarise(n = sum(count)) 

unique_dates <- unique(x_model_all_moving$date)

for (i in 1:(length(unique_dates) - w)) {
  
  date_i <- unique_dates[i]
  
  date_i_max <- date_i + w
  
  model_data <- x_model_all_moving %>%
    filter(date >= date_i & date < date_i_max) %>%
    mutate(day = as.integer(date - date_i)) %>% 
    day_of_week()
  
  
  mod <- glm(n ~ day * nhs_region + day_of_week,
             data = model_data,
             family = 'quasipoisson')
  
  # get growth rate
  r <- get_r(mod)
  r$w_min <- date_i
  r$w_max <- date_i_max
  
  # combine all estimates
  r_all_sliding_7days <- bind_rows(r_all_sliding_7days, r)
  
}

#serial interval distribution
SI_param = epitrix::gamma_mucv2shapescale(4.7, 2.9/4.7)
SI_distribution <- distcrete::distcrete("gamma", interval = 1,
                                        shape = SI_param$shape,
                                        scale = SI_param$scale,
                                        w = 0.5)

#convert growth rates r to R0
r_all_sliding_7days <- r_all_sliding_7days %>%
  mutate(R = epitrix::r2R0(r, SI_distribution),
         R_lower_95 = epitrix::r2R0(lower_95, SI_distribution),
         R_upper_95 = epitrix::r2R0(upper_95, SI_distribution))
# plot
plot_growth <-
  r_all_sliding_7days %>%
  ggplot(aes(x = w_max, y = r)) +
  geom_ribbon(aes(ymin = lower_95, ymax = upper_95, fill = nhs_region), alpha = 0.1) +
  geom_line(aes(colour = nhs_region)) +
  geom_point(aes(colour = nhs_region)) +
  geom_hline(yintercept = 0, linetype = "dashed") +
  theme_bw() +
  scale_weeks +
  theme(legend.position = "bottom",
        plot.margin = margin(0.5,1,0.5,0.5, "cm")) +
  guides(colour = guide_legend(title = "",override.aes = list(fill = NA)), fill = FALSE) +
  labs(x = "",
       y = "Estimated daily growth rate (r)") +
  scale_colour_manual(values = pal)
plot_R <- r_all_sliding_7days %>%
  ggplot(aes(x = w_max, y = R)) +
  geom_ribbon(aes(ymin = R_lower_95, ymax = R_upper_95, fill = nhs_region), alpha = 0.1) +
  geom_line(aes(colour = nhs_region)) +
  geom_point(aes(colour = nhs_region)) +
  geom_hline(yintercept = 1, linetype = "dashed") +
  theme_bw() +
  scale_weeks +
  theme(legend.position = "bottom",
        plot.margin = margin(0.5,1,0.5,0.5, "cm")) +
  guides(color = guide_legend(title = "", override.aes = list(fill = NA)), fill = FALSE) +
  labs(x = "",
       y = "Estimated effective reproduction\nnumber (Re)") +
  scale_colour_manual(values = pal)

R <- r_all_sliding_7days %>%
  mutate(lower_95 = R_lower_95, 
         upper_95 = R_upper_95,
         value = R,
         measure = "R",
         reference = 1)

r_R <- r_all_sliding_7days %>%
  mutate(measure = "r",
         value = r,
         reference = 0) %>%
  bind_rows(R)

r_R_7 <- r_R %>%
  ggplot(aes(x = w_max, y = value)) +
  geom_ribbon(aes(ymin = lower_95, ymax = upper_95, fill = nhs_region), alpha = 0.1) +
  geom_line(aes(colour = nhs_region)) +
  geom_point(aes(colour = nhs_region)) +
  geom_hline(aes(yintercept = reference), linetype = "dashed") +
  theme_bw() +
  scale_weeks +
  theme(legend.position = "bottom",
        plot.margin = margin(0.5,1,0,0, "cm"),
        strip.background = element_blank(),
        strip.placement = "outside"
  ) +
  guides(color = guide_legend(title = "", override.aes = list(fill = NA)), fill = FALSE) +
  labs(x = "", y = "") +
  scale_colour_manual(values = pal) +
  facet_grid(rows = vars(measure),
             scales = "free_y",
             switch = "y",
             labeller = as_labeller(c(r = "Daily growth rate (r)",
                                      R = "Effective reproduction\nnumber (Re)")))

Then with the 21 days window:

## set moving time window (1/2/3 weeks)
w <- 21

# create empty df
r_all_sliding_21days <- NULL

## make data for model
x_model_all_moving <- x %>%
  filter(!is.na(nhs_region)) %>% 
  group_by(date, nhs_region) %>%
  summarise(n = sum(count)) 

unique_dates <- unique(x_model_all_moving$date)

for (i in 1:(length(unique_dates) - w)) {
  
  date_i <- unique_dates[i]
  
  date_i_max <- date_i + w
  
  model_data <- x_model_all_moving %>%
    filter(date >= date_i & date < date_i_max) %>%
    mutate(day = as.integer(date - date_i)) %>% 
    day_of_week()
  
  
  mod <- glm(n ~ day * nhs_region + day_of_week,
             data = model_data,
             family = 'quasipoisson')
  
  # get growth rate
  r <- get_r(mod)
  r$w_min <- date_i
  r$w_max <- date_i_max
  
  # combine all estimates
  r_all_sliding_21days <- bind_rows(r_all_sliding_21days, r)
  
}

#serial interval distribution
SI_param = epitrix::gamma_mucv2shapescale(4.7, 2.9/4.7)
SI_distribution <- distcrete::distcrete("gamma", interval = 1,
                                        shape = SI_param$shape,
                                        scale = SI_param$scale,
                                        w = 0.5)

#convert growth rates r to R0
r_all_sliding_21days <- r_all_sliding_21days %>%
  mutate(R = epitrix::r2R0(r, SI_distribution),
         R_lower_95 = epitrix::r2R0(lower_95, SI_distribution),
         R_upper_95 = epitrix::r2R0(upper_95, SI_distribution))
# plot
plot_growth <-
  r_all_sliding_21days %>%
  ggplot(aes(x = w_max, y = r)) +
  geom_ribbon(aes(ymin = lower_95, ymax = upper_95, fill = nhs_region), alpha = 0.1) +
  geom_line(aes(colour = nhs_region)) +
  geom_point(aes(colour = nhs_region)) +
  geom_hline(yintercept = 0, linetype = "dashed") +
  theme_bw() +
  scale_weeks +
  theme(legend.position = "bottom",
        plot.margin = margin(0.5,1,0.5,0.5, "cm")) +
  guides(colour = guide_legend(title = "",override.aes = list(fill = NA)), fill = FALSE) +
  labs(x = "",
       y = "Estimated daily growth rate (r)") +
  scale_colour_manual(values = pal)
# plot
plot_R <-
  r_all_sliding_21days %>%
  ggplot(aes(x = w_max, y = R)) +
  geom_ribbon(aes(ymin = R_lower_95, ymax = R_upper_95, fill = nhs_region), alpha = 0.1) +
  geom_line(aes(colour = nhs_region)) +
  geom_point(aes(colour = nhs_region)) +
  geom_hline(yintercept = 1, linetype = "dashed") +
  theme_bw() +
  scale_weeks +
  theme(legend.position = "bottom",
        plot.margin = margin(0.5,1,0.5,0.5, "cm")) +
  guides(color = guide_legend(title = "", override.aes = list(fill = NA)), fill = FALSE) +
  labs(x = "",
       y = "Estimated effective reproduction\nnumber (Re)") +
  scale_colour_manual(values = pal)

R <- r_all_sliding_21days %>%
  mutate(lower_95 = R_lower_95, 
         upper_95 = R_upper_95,
         value = R,
         measure = "R",
         reference = 1)

r_R <- r_all_sliding_21days %>%
  mutate(measure = "r",
         value = r,
         reference = 0) %>%
  bind_rows(R)

r_R_21 <- r_R %>%
  ggplot(aes(x = w_max, y = value)) +
  geom_ribbon(aes(ymin = lower_95, ymax = upper_95, fill = nhs_region), alpha = 0.1) +
  geom_line(aes(colour = nhs_region)) +
  geom_point(aes(colour = nhs_region)) +
  geom_hline(aes(yintercept = reference), linetype = "dashed") +
  theme_bw() +
  scale_weeks +
  theme(legend.position = "bottom",
        plot.margin = margin(0.5,1,0,0, "cm"),
        strip.background = element_blank(),
        strip.placement = "outside"
  ) +
  guides(color = guide_legend(title = "", override.aes = list(fill = NA)), fill = FALSE) +
  labs(x = "", y = "") +
  scale_colour_manual(values = pal) +
  facet_grid(rows = vars(measure),
             scales = "free_y",
             switch = "y",
             labeller = as_labeller(c(r = "Daily growth rate (r)",
                                      R = "Effective reproduction\nnumber (Re)")))

And we combine both outputs into a single plot:


ggpubr::ggarrange(r_R_7,
                  r_R_21,
                  nrow = 2,
                  labels = "AUTO",
                  common.legend = TRUE,
                  legend = "bottom") 

4.3 Correlation between NHS Pathways reports and deaths by NHS region


lag_cor_reg <- data.frame()

for (i in 0:30) {

  summary <-
    all_data %>%
    group_by(nhs_region) %>%
    mutate(note_lag = lag(count, i)) %>%
    ## calculate rank correlation and bootstrap CI for each region
    group_modify(~getboot(.x)) %>%
    mutate(lag = i)
  
  lag_cor_reg <- bind_rows(lag_cor_reg, summary)
}

cor_vs_lag_reg <- 
lag_cor_reg %>%
ggplot(aes(lag, r, col = nhs_region)) +
  geom_hline(yintercept = 0, lty = "longdash") +
  geom_ribbon(aes(ymin = r_low, ymax = r_hi, col = NULL, fill = nhs_region), alpha = 0.2) +
  geom_point() +
  geom_line() +
  facet_wrap(~nhs_region) +
  scale_color_manual(values = pal) +
  scale_fill_manual(values = pal, guide = F) +  
  theme_bw() +
  labs(x = "Lag between NHS pathways and death data (days)", y = "Pearson's correlation", col = "NHS region") +
  theme(legend.position = "bottom") +
  guides(color = guide_legend(override.aes = list(fill = NA)))

cor_vs_lag_reg

5 Export data

We save the tables created during our analysis:


if (!dir.exists("excel_tables")) {
  dir.create("excel_tables")
}


## list all tables, and loop over export
tables_to_export <- c("r_all_sliding", "lag_cor")

for (e in tables_to_export) {
  rio::export(get(e),
              file.path("excel_tables",
                        paste0(e, ".xlsx")))
}

## also export result from regression on lagged data 
rio::export(lag_mod, file.path("excel_tables", "lag_mod.rds"))

6 System information

6.1 Outline

The following information documents the system on which the document was compiled.

6.2 System

This provides information on the operating system.

Sys.info()
##                                                                                            sysname 
##                                                                                           "Darwin" 
##                                                                                            release 
##                                                                                           "19.6.0" 
##                                                                                            version 
## "Darwin Kernel Version 19.6.0: Sun Jul  5 00:43:10 PDT 2020; root:xnu-6153.141.1~9/RELEASE_X86_64" 
##                                                                                           nodename 
##                                                                          "Mac-1597139943921.local" 
##                                                                                            machine 
##                                                                                           "x86_64" 
##                                                                                              login 
##                                                                                             "root" 
##                                                                                               user 
##                                                                                           "runner" 
##                                                                                     effective_user 
##                                                                                           "runner"

6.3 R environment

This provides information on the version of R used:

R.version
##                _                           
## platform       x86_64-apple-darwin17.0     
## arch           x86_64                      
## os             darwin17.0                  
## system         x86_64, darwin17.0          
## status                                     
## major          4                           
## minor          0.2                         
## year           2020                        
## month          06                          
## day            22                          
## svn rev        78730                       
## language       R                           
## version.string R version 4.0.2 (2020-06-22)
## nickname       Taking Off Again

6.4 R packages

This provides information on the packages used:

sessionInfo()
## R version 4.0.2 (2020-06-22)
## Platform: x86_64-apple-darwin17.0 (64-bit)
## Running under: macOS Catalina 10.15.6
## 
## Matrix products: default
## BLAS:   /Library/Frameworks/R.framework/Versions/4.0/Resources/lib/libRblas.dylib
## LAPACK: /Library/Frameworks/R.framework/Versions/4.0/Resources/lib/libRlapack.dylib
## 
## locale:
## [1] en_US.UTF-8/en_US.UTF-8/en_US.UTF-8/C/en_US.UTF-8/en_US.UTF-8
## 
## attached base packages:
## [1] stats     graphics  grDevices utils     datasets  methods   base     
## 
## other attached packages:
##  [1] ggnewscale_0.4.2     ggpubr_0.4.0         lubridate_1.7.9     
##  [4] chngpt_2020.5-21     cyphr_1.1.0          DT_0.15             
##  [7] kableExtra_1.1.0     janitor_2.0.1        remotes_2.2.0       
## [10] projections_0.5.1    earlyR_0.0.1         epitrix_0.2.2       
## [13] distcrete_1.0.3      incidence_1.7.2      rio_0.5.16          
## [16] reshape2_1.4.4       rvest_0.3.6          xml2_1.3.2          
## [19] linelist_0.0.40.9000 forcats_0.5.0        stringr_1.4.0       
## [22] dplyr_1.0.1          purrr_0.3.4          readr_1.3.1         
## [25] tidyr_1.1.1          tibble_3.0.3         ggplot2_3.3.2       
## [28] tidyverse_1.3.0      here_0.1             reportfactory_0.0.5 
## 
## loaded via a namespace (and not attached):
##  [1] nlme_3.1-148      fs_1.5.0          webshot_0.5.2     httr_1.4.2       
##  [5] rprojroot_1.3-2   tools_4.0.2       backports_1.1.8   utf8_1.1.4       
##  [9] R6_2.4.1          mgcv_1.8-31       DBI_1.1.0         colorspace_1.4-1 
## [13] withr_2.2.0       gridExtra_2.3     tidyselect_1.1.0  sodium_1.1       
## [17] curl_4.3          compiler_4.0.2    cli_2.0.2         labeling_0.3     
## [21] matchmaker_0.1.1  scales_1.1.1      digest_0.6.25     foreign_0.8-80   
## [25] rmarkdown_2.3     pkgconfig_2.0.3   htmltools_0.5.0   dbplyr_1.4.4     
## [29] htmlwidgets_1.5.1 rlang_0.4.7       readxl_1.3.1      rstudioapi_0.11  
## [33] farver_2.0.3      generics_0.0.2    jsonlite_1.7.0    crosstalk_1.1.0.1
## [37] car_3.0-9         zip_2.1.0         magrittr_1.5      kyotil_2019.11-22
## [41] Matrix_1.2-18     Rcpp_1.0.5        munsell_0.5.0     fansi_0.4.1      
## [45] viridis_0.5.1     abind_1.4-5       lifecycle_0.2.0   stringi_1.4.6    
## [49] yaml_2.2.1        carData_3.0-4     snakecase_0.11.0  MASS_7.3-51.6    
## [53] plyr_1.8.6        grid_4.0.2        blob_1.2.1        crayon_1.3.4     
## [57] lattice_0.20-41   cowplot_1.0.0     splines_4.0.2     haven_2.3.1      
## [61] hms_0.5.3         knitr_1.29        pillar_1.4.6      boot_1.3-25      
## [65] ggsignif_0.6.0    reprex_0.3.0      glue_1.4.1        evaluate_0.14    
## [69] data.table_1.13.0 modelr_0.1.8      vctrs_0.3.2       selectr_0.4-2    
## [73] cellranger_1.1.0  gtable_0.3.0      assertthat_0.2.1  xfun_0.16        
## [77] openxlsx_4.1.5    broom_0.7.0       rstatix_0.6.0     survival_3.1-12  
## [81] viridisLite_0.3.0 ellipsis_0.3.1